Comparative analysis of negative pressure wound therapy (PICO) and standard dressing application after arterial vascular reconstructions.

IF 1 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE Vascular Pub Date : 2024-10-26 DOI:10.1177/17085381241296606
Valentyna Kostiuk, Soraya Fereydooni, Ocean Setia, Sarah A Loh, David Strosberg, Britt H Tonnessen, Cassius Iyad Ochoa Chaar, Edouard Aboian
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Abstract

Introduction: Surgical site infections following arterial reconstructions with femoral exposures are common and potentially preventable. Negative pressure wound therapy has emerged as a potential solution to minimize groin wound complications. Our study evaluates efficacy of a negative pressure therapy (PICO dressing) in reducing groin wound complications after vascular reconstructions.

Methods: A retrospective single center comparative analysis of vascular reconstructions involving common femoral artery dissection was performed between July 2021 and June 2023. Patients were divided into two groups: patients treated with PICO device and patients who received standard dressing (non-PICO). Patient demographics, comorbidities, vascular evaluation, and procedure indications were compared. Previous interventions, incision orientation and procedure types were noted. The wound complication categories were graded according to the Szilagyi classification: grade 1 (superficial infection/minor dehiscence), grade 2 (deep infection/major dehiscence), and grade 3 (artery or prosthetic involvement). Statistical significance level was determined at p < .05 for all analyses.

Results: A total of 217 groin dissections in 184 patients were analyzed with 132 and 85 groin dissections in the PICO and non-PICO groups, respectively. The baseline characteristics were similar between the groups in terms of age, sex, BMI, and procedure indications. Prior endovascular procedures and re-operative groin surgeries were more prevalent in the PICO group. The use of antibiotics post-operatively for groin wound complication was greater in the non-PICO group. The incidence of wound complications was higher in the non-PICO group (29.4% vs 10.6%, p < .001). Multivariate logistic regression analysis determined that PICO dressing as well as hybrid and endovascular index procedures were associated with lower risks of groin complications.

Conclusion: PICO dressing decreased the incidence of groin wound complications in patients undergoing open vascular reconstructions. This study highlights the value of adjunctive negative pressure therapy in reduction of wound complications after arterial reconstructions in the inguinal region.

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动脉血管重建后负压伤口疗法(PICO)与标准敷料应用的比较分析。
导言:股外露动脉重建术后的手术部位感染很常见,而且可能是可以预防的。负压伤口疗法已成为减少腹股沟伤口并发症的潜在解决方案。我们的研究评估了负压疗法(PICO 敷料)在减少血管重建术后腹股沟伤口并发症方面的疗效:方法:我们在 2021 年 7 月至 2023 年 6 月期间对涉及股总动脉夹层的血管重建进行了回顾性单中心比较分析。患者分为两组:使用 PICO 装置治疗的患者和使用标准敷料(非 PICO)治疗的患者。比较了患者的人口统计学特征、合并症、血管评估和手术适应症。同时还记录了之前的干预措施、切口方向和手术类型。根据 Szilagyi 分类法对伤口并发症进行了分级:1 级(浅表感染/轻度开裂)、2 级(深度感染/严重开裂)和 3 级(动脉或假体受累)。所有分析的统计学意义均以 p < .05 为标准:共对 184 名患者的 217 例腹股沟撕裂进行了分析,其中 PICO 组和非 PICO 组分别有 132 例和 85 例腹股沟撕裂。两组患者在年龄、性别、体重指数和手术适应症方面的基线特征相似。在 PICO 组中,既往接受过血管内手术和腹股沟再次手术的比例更高。非 PICO 组术后因腹股沟伤口并发症使用抗生素的比例更高。非 PICO 组的伤口并发症发生率更高(29.4% vs 10.6%,p < .001)。多变量逻辑回归分析表明,PICO敷料以及杂交和血管内指数手术与较低的腹股沟并发症风险相关:结论:PICO 敷料降低了开放血管重建患者腹股沟伤口并发症的发生率。这项研究强调了辅助负压疗法在减少腹股沟区域动脉重建术后伤口并发症方面的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Vascular
Vascular 医学-外周血管病
CiteScore
2.30
自引率
9.10%
发文量
196
审稿时长
6-12 weeks
期刊介绍: Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.
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